One of my children is heavily autistic and nonverbal at 6. He had constipation issues before which made him fearful of going #2. He trained himself to just never have a bowel movement, so he soils his diapers all day (his bowls are full and it’s the natural progression out). It concerns me because he’s continuously backed up and that’s not good for his long term health.
Doctors have been little help. The gastro put him in the hospital with a drip to essentially clear him out completely but a week after we were back in the same boat. Our pediatrician has us giving him laxatives daily, and even though we do, this doesn’t change the situation. The ABA school he goes to takes him to the bathroom very routinely but this also seems to be ineffective. I’ve tried putting him on the toilet after meals (he’s cooperative to sit there), but he seems to still hold back.
Is there some place we can go to for help?
It’s really great that you’re seeking help and talking openly about this! Encopresis is too often shameful and kids suffer when parents don’t speak up.
There’s lots of conflicting advice out there and I strongly recommend you find pediatric autism specialist if as all possible. A generalist MD or therapist is not likely to be knowledgable about this topic.
This website, despite the sales pitch, has good information and a detailed manual. It might be worth reading. https://www.encopresis.com/encopresis-manual/
Editing to add that interoception may be part of the issue. People with ASD often have more distant perceptions of internal bodily sensations than allistics, so your son may only perceive his need to defecate at a 1/10 where another kid might feel it at a 7/10. Teaching body check ins and mindfulness can be helpful, but is tricky with young kids.
Thank you very much!
Yes! Interoception is considered the 8th sensory system and ties in with the sensory processing differences common in autism. An occupational therapist familiar with interoception can help. Kelly Mahler has some good resources (and a whole curriculum for sale, but look for the free stuff).
Does he have a therapist? You may want to look in your area for someone who specializes in Austic chicken. Hopefully there is someone, but it’s a speciality.
Austic chicken
I’m just going to leave that now.
Thanks!
Have you tried stomach massage? It can help. If he’s spending time sitting on the toilet anyway maybe try a massage instead. Might also help diffuse any mental anxiety/pressure about toileting by adding something new. Could take time and effort to have an effect so approach with patience.
Also I assume your paediatrician has mentioned the usual things that can help: hydration, walking, fiber. Small changes can add up.
Thanks!
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